| Primary Care Center Of Clear Lake | |
|
360 E Medical Center Blvd Ste A Webster TX 77598-4321 | |
| (832) 932-5669 | |
| (832) 932-5249 |
| Full Name | Primary Care Center Of Clear Lake |
|---|---|
| Speciality | Internal Medicine |
| Location | 360 E Medical Center Blvd Ste A, Webster, Texas |
| Authorized Official Name and Position | Smriti Dubey Choudhary (PRACTICE ADMINSTRATOR) |
| Authorized Official Contact | 7134168987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Center Of Clear Lake 360 E Medical Center Blvd Ste A Webster TX 77598-4321 Ph: (832) 932-5669 | Primary Care Center Of Clear Lake 360 E Medical Center Blvd Ste A Webster TX 77598-4321 Ph: (832) 932-5669 |
| NPI Number | 1356674584 |
|---|---|
| Provider Enumeration Date | 09/04/2009 |
| Last Update Date | 04/08/2021 |
| Medicare PECOS PAC ID | 7416961792 |
|---|---|
| Medicare Enrollment ID | O20091111000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356674584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L2845 (Texas) | Primary |
| Provider Name | Smriti D Choudhary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619971553 PECOS PAC ID: 6507828274 Enrollment ID: I20041103001250 |
| Provider Name | Niraj Choudhary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013906684 PECOS PAC ID: 3779597059 Enrollment ID: I20060126000386 |
| Provider Name | Amy Elizabeth Mcconkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326590092 PECOS PAC ID: 4981989613 Enrollment ID: I20170321001312 |
| Provider Name | Carissa A Ainsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578108254 PECOS PAC ID: 7911331566 Enrollment ID: I20200107002150 |
| Provider Name | Janet Elizabeth Metts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366082901 PECOS PAC ID: 4981026168 Enrollment ID: I20200616002010 |
| Provider Name | Ifedapo Olubukola Sotubo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063000909 PECOS PAC ID: 6901203876 Enrollment ID: I20210920001366 |
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